Graduation Year

2026

Document Type

Thesis

Degree

M.S.

Degree Name

Master of Science (M.S.)

Degree Granting Department

Communication Sciences and Disorders

Major Professor

Hana Kim, Ph.D.

Committee Member

Gerald Imaezue, Ph.D.

Committee Member

Christos Salis, Ph.D.

Keywords

cognitive performance, communication disorders, multilevel linguistic analysis, speech-language pathology, stroke rehabilitation

Abstract

Objective:Standardized assessments such as the Western Aphasia Battery-Revised do not reliably detect subtle language impairments in mild aphasia (Dalton & Richardson, 2015). Discourse tasks may provide a more sensitive measure of impairment. Although discourse tasks differ in cognitive demands (Kim & Kintz, 2024), variation in discourse performance across tasks and the influence of cognition remains unclear. Therefore, this study examined (1) whether discourse performance differs across different discourse elicitation tasks, and (2) the extent to which cognition influences discourse performance in individuals with mild aphasia.

Participants & Methods: Fifteen participants with mild aphasia participated (mean age = 62.7 years). Discourse samples were elicited using sequential picture, storytelling, and expository tasks and analyzed using a multi-level linguistic analysis framework (Marini et al., 2011). Cognitive measures assessed working memory, short-term memory, inhibition, cognitive flexibility, and attention.

Results:Friedman tests showed no significant differences in micro-level discourse errors across tasks. However, significant differences were found in macro-level discourse errors. Post hoc Wilcoxon signed-rank tests showed significantly more macro-level errors during expository tasks than storytelling tasks with a large effect size and more errors during sequential picture tasks than storytelling tasks with a large effect size. Spearman’s correlations demonstrated significant relationships between discourse performance and cognitive performance. At the micro-level, working memory, cognitive flexibility, and attention were associated with storytelling and expository tasks, while working memory and cognitive flexibility were associated with sequential picture tasks. At the macro-level, cognitive flexibility and attention were associated with storytelling and sequential picture tasks.

Conclusion:Discourse production in mild aphasia varied by discourse task type, particularly at the macro-linguistic level. Storytelling tasks resulted in fewer macro-level errors than expository and sequential picture tasks. These findings suggest that macro-level discourse performance is task-sensitive in this population. Cognitive abilities were associated with both micro- and macro-level discourse performance, indicating that cognition contributes to lexical retrieval as well as higher-level discourse planning and monitoring processes.

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